Seated Exercise Series: Chair Aerobics
Kristina Sandstedt, MS, Clinical Exercise Physiologist,
Diabetes Educator

Part Three: Chair Aerobics:

As previously stated in parts 1 & 2, seated aerobic exercises are designed to help individuals with diabetes who suffer from chronic complications (e.g. severe peripheral neuropathy, severe peripheral vascular disease, unstable congestive heart failure and morbid obesity) achieve improved blood sugar control and improved cardiovascular health. Unfortunately individuals who suffer from these devastating complications often do not engage in exercise programs. It is imperative for this group to participate in physical activity programs to improve or maintain their functional capacity and strength. Keep in mind, this may be the stepping stone you need to achieve your goal of participating in low-level aerobic, or more active, exercise.
When performing these exercises, remember that aerobic exercises are rhythmical in nature and this rhythm should be sustained for at least 20-30 minutes. If you are just starting this particular exercise program it is best to break up the exercise session into 5-10 minute bouts 2-3 times per day, gradually progressing to continuous bouts of 30 minutes of exercise once a day. Performing these particular exercises in longer duration will help your overall functional capacity which can make your activities of daily living (e.g. grocery shopping, laundry, gardening, yard work) easier.

Exercises 1 & 2



Exercises 3 & 4:



Exercises 5 & 6:

 


Although seated exercises are low impact and are typically performed indoors, I feel it is important to provide information regarding the potential hazards of exercising at any level during the warmest months of the year. Exercising during the summer months can be dangerous for any exerciser if they do not maintain adequate levels of hydration. Prevention of dehydration and heat related illnesses should be part of the exercise education.

Physiologically, the human body produces 5-10 times more heat during exercise versus rest. Excess heat is dissipated through sweat and is often understood as the human cooling system. Humidity interferes with sweat evaporation and cooling becomes more and more difficult. If the body is under a state of dehydration it cannot cool itself efficiently and the body’s ability to sweat becomes more and more compromised. As a result, the body will try to keep blood away from the skin to keep blood pressure appropriate at the core level in order to sustain cardiac output. Eventually, an ongoing battle between the skin and the muscles takes place as leg and arm muscles demand more blood in order to supply much needed oxygen and vital nutrients to sustain the muscle contraction and relaxation. At the same time the skin needs an adequate amount of blood sent in its direction to transport the heat to the peripheral level to cool the body off. The cardiovascular system is caught in the middle trying to satisfy both mechanisms. As a result, heart rate increases to sustain stroke volume which is necessary to maintain cardiac output.

Signs of heat related illnesses and dehydration:
Heat Exhaustion: Overall weakness, headache or dizziness, rapid heartbeat, cold clammy skin and nausea. These signs and symptoms begin suddenly, sometimes after excessive perspiration and inadequate fluid intake.

Heat Stroke: Elderly and obese individuals are at highest risk. Other risk factors for heat stroke include constant daily dehydration, alcohol use, heart disease and vigorous exercise. Heat stroke occurs when the body loses the battle with heat exhaustion. The body stops sweating and temperature rises rapidly, heartbeat is rapid and shallow breathing occurs. Victims may become delirious and/or confused. Fainting can be the first sign in the elderly.

Dehydration: Marked thirst, infrequent urination, dry mouth, nausea, headache, dizziness and or light-headedness.
Heat Cramps: Painful muscle spasms. Usually occurs after vigorous exercise and possibly during the nighttime when individuals are asleep.

It is important for health care professionals to share with their patients’ safety tips to ensure safe outdoor exercise.
Some of these symptoms also parallel symptoms of low blood sugar, therefore carrying your meter along with glucose tablets and water in a waist pack is always wise.

Tips for safe exercise during the summer months:
1. If the temperature is greater than 85 degrees and the humidity is greater than 75%, it is best to exercise indoors. If outdoors is a must, exercise early in the morning, after breakfast or later in the evening after your evening meal. Always avoid the 10am-4pm window as temperatures are at their peak.
2. Always wear loose-fitting, light colored, cotton or mesh clothing. Shorts, a sleeveless shirt, low cut socks and a hat are recommended to aid in heat loss (e.g. sweat).
3. Drink plenty of water, at least 64oz/day if not more considering the amount lost during exercise. Avoid sports drinks as they contain many carbohydrates. It is a good idea to carry bottled water during exercise and try to consume 4-8oz. of water every 15 minutes during moderate aerobic exercise.
4. Always start exercise with a 5-10 minute warm-up and finish the exercise with another 5-10 minute active cool-down.
5. Be sensible about your levels of exertion, and listen to your body.
6. Gardening and other various types of yard work are considered lifestyle activities and although they do not aid in improving cardiovascular fitness, it can put you at risk for a heat-related illness if heavy amounts are performed during the 10am-4pm window.

References:
Diabetes Management Therapies, a core curriculum for Diabetes Education, Fourth Edition. The American Association of Diabetes Educators, 2001.
The “I hate to exercise book” for people with diabetes. Charlotte Hayes, MMSc, MS, RD, CDE. American Diabetes Association, 2000.
The Best is yet to come, an exercise handbook.. D. Bruckerhoff, RN, Certified Exercise Specialist. Boone Hospital Center, WELLAWARE.


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